The young mother’s dietary may well be made up from the groups of foods that are suitable for the expectant mother. (See Chapter VI). At this time, as during pregnancy, she must avoid all food which may produce any form of indigestion, but for the baby’s sake, now, as well as her own. While it is not generally believed, to-day, that there are many, if any articles of diet which in themselves affect the mother’s milk unfavorably, it is generally conceded that a derangement of her digestion may, and usually does, have a deleterious effect upon her milk, and therefore upon the baby.
The old, and widespread, belief that certain substances from such highly flavored vegetables as onions, cabbage, turnips and garlic are excreted through the milk, to the baby’s detriment, is not given general credence to-day. On the other hand, it is known, however, that certain protective substances in certain foods are excreted through the milk, to the baby’s distinct advantage, and it is therefore, important that the mother’s diet should regularly contain those articles of food which contain them. These foods are milk; egg yolk; glandular organs, such as sweet-breads, kidneys and liver; the green salads, such as lettuce, romaine, endive and cress and the citrus fruits, or oranges, grapefruit and lemons.
These are called “protective foods” because they protect the body against the so-called deficiency diseases known as scurvy, beri-beri, xerophthalmia, which with rickets and pellagra are discussed in the chapter on Nutrition. It is possible for a baby who nurses at the breast of a woman whose diet is poor in protective foods, to be so insufficiently nourished, in some particular, as to be on the border line of one of these diseases, or even to develop the disease itself. This is one reason for the statement that the nursing mother must “eat for two.”
Certain drugs are excreted through the milk and may affect the baby in the same way as though they were administered directly, for example: salicylic acid, potassium iodid, lead, mercury, iron, arsenic, atropine, chloral, alcohol and opium.[[9]]
In addition to her food the nursing mother should have an abundance of water to drink, and to facilitate this it is a good plan to keep a pitcher or thermos bottle of water on the bedside table, and replenish it regularly, every four hours.
In general, the young mother should have light, nourishing, easily digestible food, with little, if any meat; an abundance of cereals, creamed dishes, creamed soups, eggs, salads and the fresh fruits and vegetables which ordinarily agree with her; at least a quart of milk, daily, in addition to that which is used in preparing her meals, and an abundance of water to drink.
The Bowels. The puerperal patient is almost always constipated, and needs assistance in regaining regularity in the movements of her bowels.
The routine use of cathartics and enemata varies, but it is very common to give an enema on the second morning after delivery or castor oil or Rochelle salts, followed by an enema if necessary. After this, a mild cathartic or a low enema is given often enough to produce a daily movement when this is not accomplished by means of the diet.
Some doctors, however, prefer that the bowels shall not move for four or five days after delivery, believing that this delay reduces the danger of infection from the intestinal contents, which are swarming with organisms, particularly the colon bacillus.
In cases of third degree tears, catharsis is practically always delayed for four to six days in order that the torn edges of the rectal sphincter may become well united before being strained by a bowel movement. In these cases an enema of six or eight ounces of warm olive oil is often given and the patient encouraged to retain it over night, in order to soften the contents of the rectum and lessen the strain and irritation of evacuation.